The importance of end-of-life planning

If making end-of-life plans is a topic you’d prefer to put off, you’re far from alone. It’s a sensitive subject. Unfortunately, delaying or deciding not to make plans may add stress, pain and confusion for yourself and your loved ones when that day comes. Health care professionals have been encouraging people to spell out their wishes for how their final days should be handled for about 50 years. But a study by the University of Pennsylvania in 2017 showed that only about one-third of Americans have followed that advice and put their end-of-life wishes down on paper. Even though death is a difficult topic, designating who you want to make your health care decisions and specifying your wishes for life support and specific end-of-life medical treatments can provide health professionals with clear guidance about your desires and ease stress for family members.

Key documents

The two most important documents are a living will, also known as an advanced directive, and a durable power of attorney for health care. A living will/advanced directive is a written statement specifying a person’s desires regarding their medical treatment if they can no longer provide informed consent. A power of attorney for health care is used to name a person who will make health care decisions on your behalf if you are unable to speak for yourself.Dr. Anthony Germinario, co-chief resident of the Tidelands Health MUSC Family Residency Program, says it is not uncommon for health care providers to encounter a situation in which family members have opposing views about how a patient should be treated. “When decisions must be made regarding extraordinary measures, putting a loved on a breathing machine, or in some instances, withdrawing medical care, this can be an enormous source of stress, conflict and confusion if proper planning has not occurred,” Dr. Germinario says.

Advocacy

To help avoid that circumstance, a group of resident physicians at Tidelands Health have been focused over the past year on an advocacy project that has gotten folks talking about end-of-life planning. They’ve led discussions at local libraries and nursing homes. They’ve also introduced people to the importance of the “Five Wishes,” a step-by-step guide for end-of-life planning from the national non-profit Aging with Dignity. People, even those who are young and currently healthy, are asked to think about:

Who would make my care decisions for me when I cannot?

What kind of medical treatment do I want or don’t want?

How comfortable would I want to be?

How do I want people to treat me?

What do I want my loved ones to know?

As a precaution, when patients are admitted to Tidelands Health hospitals they are asked to specify their wishes should an unexpected event occur that might require extraordinary medical care, such as mechanical breathing. Dr. Germinario acknowledges that talking about your own death or that of a loved one isn’t easy. As difficult as it may be to discuss, end-of-life planning brings peace of mind. “It brings comfort when people know their wishes will be honored in a circumstance where they are unable to make decisions for themselves,” Dr. Germinario says. “They also know their family will face less stress in this type of scenario.” Bringing up the topic of end-of-life planning with a loved one should be handled sensitively. “The question must come from a place of love and respect for the loved one,” he says. “It should be an honest discussion and center around wanting to respect the loved one’s wishes and autonomy.”